Neonatal brainstem function and 4-month arousal-modulated attention are jointly associated with autism.
Neonatal brainstem function and 4-month arousal-modulated attention are jointly associated with autism.
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DOI：
10.1002/aur.1259
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发表时间：
2013-02
期刊：
影响因子：
4.7
通讯作者：
Barone, Anthony
中科院分区：
文献类型：
--
作者：
Cohen, Ira L.;Gardner, Judith M.;Karmel, Bernard Z.;Phan, Ha T. T.;Kittler, Phyllis;Gomez, Tina Rovito;Gonzalez, Maripaz G.;Lennon, Elizabeth M.;Parab, Santosh;Barone, Anthony
关键词：
据报道，新生儿重症监护室（NICU）毕业生在四个月大的时候喂养后进行测试时，对高刺激率的偏好更强，后来被诊断出患有自闭症。这种视觉偏好是新生儿的典型特征，很可能是由脑干中的唤醒系统介导的，并且在四个月时应该不再存在。事实上，这种现象在后来发展为自闭症的婴儿中持续存在，这表明他们可能有非典型的脑干发育或功能。有一组新生儿最初未能通过听觉脑干反应筛查（ABR;脑干听觉通路完整性的测量），但最终在出院时恢复，这表明他们具有非典型的脑干发育。因此，我们研究了ABR功能沿着4个月奥尔兹对高刺激率的偏好的问题在多大程度上预测了幼儿和学龄前儿童自闭症的后期发生。我们发现，在4个月时，对较高刺激率的偏好与后来的自闭症严重程度和语言发育问题的测量高度相关，但仅限于那些最初有异常ABR的人。得出的结论是，最初异常的新生儿ABR和偏好更多的刺激，在四个月的联合发生，这两个指标的早期脑干功能障碍，可能是自闭症的发展标志。作者评估了新生儿重症监护病房（NICU）毕业生中最初异常的新生儿听觉脑干反应（ABR）和4个月的唤醒调节注意视觉偏好对后期自闭症谱系障碍（ASD）行为的贡献。采用纵向研究设计，比较NICU毕业生正常ABR（n=28），那些最初异常ABR（n=46），后来解决。在足月后4个月时，对以1、3或8 Hz闪烁的随机检查模式的视觉偏好（喂养后测量）和胎龄（GA）作为额外的预测因素。结果测量为3.4（SD=1.2）岁时的PDD行为量表（PDDBI）评分，以及使用格里菲斯精神发育量表（GMDS）在相同年龄获得的DQ。4个月时对更高刺激率的偏好与PDDBI评分（所有p值均<.01）和GMDS听力和言语DQ高度相关，但仅在最初异常ABR的患者中。与自闭症诊断最相关的PDDBI社交能力测量效果最强。对于那些异常ABR的人，婴儿时期对更高刺激率的偏好增加与三岁时ASD严重程度的非线性增加和ASD诊断有关。异常ABR与后来报告的重复和仪式化的行为，无论四个月的刺激偏好。最初异常的新生儿ABR和偏好更多的刺激在四个月的联合发生，这两个指标的早期脑干功能障碍，可能是自闭症的发展在这个队列中的一个标志。
A stronger preference for high rates of stimulation when tested after feeding at four months of age has been reported in Neonatal Intensive Care Unit (NICU) graduates who later were diagnosed with autism relative to those who were not. This visual preference is typical of newborns, is likely mediated by arousal systems in the brainstem, and should no longer be present by four months. The fact that it was so persistent in babies who later developed autism suggested they may have had atypical brainstem development or functioning. There exists a group of newborns who initially fail Auditory Brainstem Response screens (ABRs; a measure of the integrity of their brainstem auditory pathways) but eventually recover by hospital discharge suggesting they have atypical brainstem development. We therefore examined the extent to which this problem with ABR functioning along with four-month-olds’ preference for high rates of stimulation predicts the later occurrence of autism in toddlers and preschoolers. We found that preference for higher rates of stimulation at four months was highly associated with later measures of autism severity and with language development problems but only in those who had initially abnormal ABRs. It was concluded that the joint occurrence of initially abnormal neonatal ABRs and preference for more stimulation at four months, both indices of early brainstem dysfunction, may be a marker for the development of autism. The authors evaluated the contribution of initially abnormal neonatal Auditory Brainstem Responses (ABRs) and four month Arousal Modulated Attention visual preference to later Autism Spectrum Disorder (ASD) behaviors in Neonatal Intensive Care Unit (NICU) graduates. A longitudinal study design was used to compare NICU graduates with normal ABRs (n=28) to those with initially abnormal ABRs (n=46) that later resolved. At four months post-term-age, visual preference (measured after feeding) for random check patterns flashing at 1, 3, or 8 Hz, and gestational age (GA) served as additional predictors. Outcome measures were PDD Behavior Inventory (PDDBI) scores at 3.4 (SD=1.2) years, and DQs obtained around the same age with the Griffiths Mental Development Scales (GMDS). Preferences for higher rates of stimulation at four months were highly correlated with PDDBI scores (all p values <.01), and the GMDS Hearing and Speech DQ but only in those with initially abnormal ABRs. Effects were strongest for a PDDBI social competence measure most associated with a diagnosis of autism. For those with abnormal ABRs, increases in preference for higher rates of stimulation as infants were linked to non-linear increases in severity of ASD at three years and to an ASD diagnosis. Abnormal ABRs were associated with later reports of repetitive and ritualistic behaviors irrespective of four month preference for stimulation. The joint occurrence of initially abnormal neonatal ABRs and preference for more stimulation at four months, both indices of early brainstem dysfunction, may be a marker for the development of autism in this cohort.
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影响因子：
14.5
作者：
Bailey, A;Luthert, P;Lantos, P
通讯作者：
Lantos, P
影响因子：
3.9
作者：
Ben-Yizhak, Noa;Yirmiya, Nurit;Seidman, Ifat;Alon, Raaya;Lord, Catherine;Sigman, Marian
通讯作者：
Sigman, Marian
影响因子：
3.9
作者：
Cohen, Ira L.;Gomez, Tina Rovito;Gardner, Judith M.
通讯作者：
Gardner, Judith M.
DOI：
10.1016/j.cub.2011.12.056
发表时间：
2012-02-21
期刊：
Current biology : CB
影响因子：
--
作者：
Elsabbagh M;Mercure E;Hudry K;Chandler S;Pasco G;Charman T;Pickles A;Baron-Cohen S;Bolton P;Johnson MH;BASIS Team
通讯作者：
BASIS Team
影响因子：
8
作者：
Karmel BZ;Gardner JM;Meade LS;Cohen IL;London E;Flory MJ;Lennon EM;Miroshnichenko I;Rabinowitz S;Parab S;Barone A;Harin A
通讯作者：
Harin A